LeadUS Mentoring Program 2015-16

Name*

Last NameFirst Name

Date*

Date

Email*

Address*

Street Address

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Phone Number*

Area CodePhone

Birth Date*

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Place of Birth

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Gender Identity

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Company/Organization*

Email*

Address*

Street Address

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Please list your current and past Board experiences*

What are your current associations and/or club affiliations (include titles if possible)*

Please list your skills and expertise*

What is your educational background?*

Please describe in detail some of your greatest strengths and weaknesses*

What do you feel is essential to ensure that the Board and staff are successful in attaining the goals for this organization? *

What experiences, expertise, connections, or resources would you bring to the Color Codes Foundation? *

Please detail your interest in joining this Board*

What type of Board tasks do you prefer?*

Directors of the CCF Board might take on special projects in addition to their Board responsibilities to assist CCF with Workshop and Mentorship initiatives. Please let us know if you have any specific project ideas you would like to propose. *

Have you ever been engaged in any specific fundraising efforts? If so with whom, how, and what was the amount raised? Are you comfortable playing an active role in assisting CCF with fundraising efforts? *

The CCF Board will initially have 4 standing committees: (1) Board Building & Governance, (2) Development and Resources, (3) Finance & Internal Affairs, and (4) Fundraising and Sponsorships. Please check all that you would be interesting in joining.*

Board Building & GovernanceDevelopment and ResourcesFinance & Internal AffairsFundraising and Sponsorships

How much time would you have to dedicate to Color Codes Foundation (a week, a month, etc…)?*

The Color Codes Foundation's Board is an engaged and exciting working board. Board members are required to attend a minimum of 2 board meetings annually (in person or zoom), scheduled committee meetings, special events, and attend monthly board check-ins. Board members are expected to be professional, timely and present at every meeting with a maximum of two absences across all meetings for the year. Board members must give a two-year commitment (can be renewed up to three times) and approx. 3-5 hours per month. Members are also encouraged to participate in fundraising and program development activities, which could include the annual Freedom Fundraiser and Sister Bonds Gala.

After your application has been reviewed you may be asked to interview in order for us to get better acquainted with you. Please have a list of references available upon request. Thank you for your interest.

I certify, by my signature, that the information contained within this application and all supporting documents (i.e., resume, recommendation letters, etc.) is true, accurate, and complete to the best of my knowledge. An electronic signature is accepted.

Signature________________________ ___________ __Date_____________

The Color Codes Foundation does not discriminate on any basis including race, sex, age, religion,

Board of Directors Applicant Form

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